Pharmacist Intervention to Improve Medication Adherence in Heart Failure

Murray, Michael D.; Young, James; Hoke, Shawn; Tu, Wanzhu; Weiner, Michael; Morrow, Daniel G.; Stroupe, Kevin T.; Wu, Jingwei; Clark, Daniel O.; Smith, Frederick; Gradus‐Pizlo, Irmina; Weinberger, Morris; Brater, D. Craig

doi:10.7326/0003-4819-146-10-200705150-00005

Cited by 402 publications

(463 citation statements)

References 50 publications

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“…[37][38][39] Of note, the MEPS prescription medication expenditures included pharmacy records which tracked both insurance and out-ofpocket expenses. Insurance type was included in the adjusted analysis; therefore, the increased costs are less likely to be due to differences in private, public, or self-insurance coverage.…”

Section: Discussionmentioning

confidence: 99%

Health Literacy Impact on National Healthcare Utilization and Expenditure

Rasu

Bawa

Suminski

et al. 2015

Int J Health Policy Manag

158

137

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Background: Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. We evaluated the impact of low health literacy (LHL) on healthcare utilization and healthcare expenditure. Methods: Database analysis used Medical Expenditure Panel Survey (MEPS) from 2005-2008 which provides nationally representative estimates of healthcare utilization and expenditure. Health literacy scores (HLSs) were calculated based on a validated, predictive model and were scored according to the National Assessment of Adult Literacy (NAAL). HLS ranged from 0-500. Health literacy level (HLL) and categorized in 2 groups: Below basic or basic (HLS <226) and above basic (HLS ≥226). Healthcare utilization expressed as a physician, nonphysician, or emergency room (ER) visits and healthcare spending. Expenditures were adjusted to 2010 rates using the Consumer Price Index (CPI). A P value of 0.05 or less was the criterion for statistical significance in all analyses. Multivariate regression models assessed the impact of the predicted HLLs on outpatient healthcare utilization and expenditures. All analyses were performed with SAS and STATA ® 11.0 statistical software. Results: The study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally from [2005][2006][2007][2008]. The cohort had an average age of 49 years and included more females (57%). Caucasian were the predominant racial ethnic group (83%) and 37% of the cohort were from the South region of the United States of America. The proportion of the cohort with basic or below basic health literacy was 22.4%. Annual predicted values of physician visits, nonphysician visits, and ER visits were 6.6, 4.8, and 0.2, respectively, for basic or below basic compared to 4.4, 2.6, and 0.1 for above basic. Predicted values of office and ER visits expenditures were $1284 and $151, respectively, for basic or below basic and $719 and $100 for above basic (P < .05). The extrapolated national estimates show that the annual costs for prescription alone for adults with LHL possibly associated with basic and below basic health literacy could potentially reach about $172 billion. Conclusion: Health literacy is inversely associated with healthcare utilization and expenditure. Individuals with below basic or basic HLL have greater healthcare utilization and expendituresspending more on prescriptions compared to individuals with above basic HLL. Public health strategies promoting appropriate education among individuals with LHL may help to improve health outcomes and reduce unnecessary healthcare visits and costs. Implications for policy makers• Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. •We found that individuals with below basic or basic compared to above basic health literacy incurred more healthcare visits, have greater total healthcare expenditures. • Adults with basic or below basic health literacy incurred greater costs for prescription ($3362) than adults w...

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Section: Discussionmentioning

confidence: 99%

Health Literacy Impact on National Healthcare Utilization and Expenditure

Rasu

Bawa

Suminski

et al. 2015

Int J Health Policy Manag

158

137

View full text Add to dashboard Cite

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“…Randomized controlled studies have shown that pharmacists improve medication and lifestyle adherence as part of a multidisciplinary team. [36][37][38][39][40] Some of these studies also demonstrated improvements in patients' clinical outcomes. 36,37,[39][40][41] Studies Assessing Medication Adherence A summary of studies evaluating pharmacist interventions on medication adherence is presented in Table 3.…”

Section: Pharmacist Interventions To Improve Adherencementioning

confidence: 99%

“…36,37,[39][40][41] Studies Assessing Medication Adherence A summary of studies evaluating pharmacist interventions on medication adherence is presented in Table 3. [36][37][38][39][40][41][42][43][44] One of the earliest randomized controlled trials that assessed the effect of intensive pharmacist counseling randomized 100 elderly patients with stable HF in the United Kingdom to a 3-month pharmacist counseling intervention versus standard care. 40 Medication adherence, per pill count, was 93% for the intervention group and 51% for the control group post-intervention (P < 0.001).…”

Section: Pharmacist Interventions To Improve Adherencementioning

confidence: 99%

The Pharmacist Role in Predicting and Improving Medication Adherence in Heart Failure Patients

Davis

Packard²,

Jackevicius

2014

JMCP

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“…Among the health literacy interventions AHRQ reviewed, those that demonstrated the potential to effectively improve health outcomes were again focused on selfmanagement and treatment adherence. 35 A closer look at the few "effective" health literacy interventions highlighted in the report reveals three randomized controlled trials [45][46][47] that tested strategies particularly well-suited for implementation within a PCMH: individualized communication, scheduled phone follow-up, and team-based care, among others ( Table 1).…”

Section: A Synergistic Approach To Cost Quality and Disparitiesmentioning

confidence: 99%

“…The difference was larger for low-literacy patients than for high-literacy patients. Patients with low literacy and other vulnerable populations are likely to benefit most from such programs Murray MD, Young J, Hoke S, et al 47 A pharmacist-led intervention for outpatients with heart failure featuring patient-centered verbal instructions and clear written instructions that made use of icons and an easy-to-follow timeline. The pharmacist worked with a multi-disciplinary team…”

Section: A Synergistic Approach To Cost Quality and Disparitiesmentioning

confidence: 99%

Can Integrating Health Literacy into the Patient-centered Medical Home Help us Weather the Perfect Storm?

2012

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Improving health literacy is one key to buoying our nation's troubled health care system. As system-level health literacy improvement strategies take the stage among national priorities for health care, the patientcentered medical home (PCMH) model of care emerges as a compelling avenue for their widespread implementation. With a shared focus on effective communication and team-based care organized around patient needs, health literacy principles and the PCMH are well aligned. However, their synergy has received little attention, even as PCMH demonstration projects and health literacy interventions spring up nationwide. While many health literacy interventions are limited by their focus on a single point along the continuum of care, creating a "room" for health literacy within the PCMH may finally provide a multi-dimensional, systemlevel approach to tackling the full range of health literacy challenges. Increasing uptake coupled with federal support and financial incentives further boosts the model's potential for advancing health literacy. On the journey toward a revitalized health care system, integrating health literacy into the PCMH presents a promising opportunity that deserves consideration.

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Pharmacist Intervention to Improve Medication Adherence in Heart Failure

Cited by 402 publications

References 50 publications

Health Literacy Impact on National Healthcare Utilization and Expenditure

Health Literacy Impact on National Healthcare Utilization and Expenditure

The Pharmacist Role in Predicting and Improving Medication Adherence in Heart Failure Patients

Can Integrating Health Literacy into the Patient-centered Medical Home Help us Weather the Perfect Storm?

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